Repeal of Obamacare could be 'devastating' for R.I., governor says

Tuesday

Dec 13, 2016 at 9:54 PMDec 13, 2016 at 9:54 PM

The $130 million in federal matching funds R.I. plans to deploy over the next five years to revamp its insurance program for the poor would likely dry up under the changes laid out by President-elect Donald Trump, federal health officials said Tuesday.

Lynn Arditi Journal staff writer lynnarditi

PROVIDENCE — The $130 million in federal matching funds Rhode Island plans to deploy over the next five years to revamp its insurance program for the poor would likely dry up under the changes laid out by President-elect Donald Trump, federal health officials said Tuesday.

In his campaign manifesto, Trump said Congress must repeal the Affordable Care Act, known as Obamacare, and give each state a lump sum of federal money — a block grant — for Medicaid.

"The state and federal partnership to invest will not be possible under a block grant," Kathryn E. Martin, acting assistant secretary for planning and evaluation at the U.S. Department of Health and Human Services in Washington, said during a media conference call about a new report about the ACA's impact on states. "It could jeopardize some of the most innovative things states are doing" to bring down costs and improve health outcomes.

Gov. Gina Raimondo said Tuesday during a meeting at The Providence Journal that she "loses sleep" over the prospect of a hasty unrolling of the Affordable Care Act and its Medicaid payment system. "It could be devastating for us," she said.

Less than three weeks before the presidential election, the federal Centers for Medicare & Medicaid Services approved Rhode Island's plan to use the $130 million in federal Medicaid matching funds to create new payment models that offer financial incentives to reduce costs and improve health outcomes. The state also has received approval for the first time to use some of the federal money to invest in the state's three public colleges to train students for health-care jobs.

"That's exactly the type of partnership that would go away with block grants," Marjorie K. Connolly, the HHS's national press secretary, said in an email when asked specifically about the $130 million in federal funding.

Rhode Island is among 31 states, along with the District of Columbia, which expanded eligibility for Medicaid under the Affordable Care Act. Nearly 300,000 Rhode Island residents — almost a third of the state's population — are currently served by the Medicaid program. That includes an estimated 22,000 residents who gained health insurance because Rhode Island expanded Medicaid under the ACA, the federal HHS said in a statement.

"The states that have seen the greatest gains under the ACA are at the greatest risks," Martin, of HHS, said. "So states like Rhode Island … are at great risks of losing those coverage gains …"